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Shoulder Pain: Why Does It Happen and How Can You Improve It?

Shoulder pain occurs in both men and women of all ages. It is not uncommon for the pain to radiate to the back, neck, and down the arm to the fingers. Shoulder pain can occur suddenly when exercising or lifting heavy objects. Acute shoulder pain can also often be triggered by lying on your arm at night.

How common is shoulder pain?

Most shoulder pain (85%) does not come from the shoulder joint itself. Therefore, the triggering factors should not only be determined near the joint. Shoulder pain can be triggered by disease-related or injury-related damage to tendons, muscles, joint capsules, and pre-existing joint wear. But liver disease, gallbladder disease, or a heart attack can also cause shoulder pain.

Onset and Duration of Shoulder Pain

Shoulder pain is divided into acute and chronic pain. If it appears suddenly after a fall or accident, it can be caused by a dislocated shoulder, a fracture of the upper arm, or an injury to the bicep tendon. This type of pain is called acute shoulder pain.

Chronic shoulder pain is constant it is a pain whose evolution over time is on the rise, becoming increasingly unbearable. An example of this is the wear of the joints, and osteoarthritis. If a herniated disc in the cervical spine region becomes symptomatic, serious discomfort in the shoulder joint can occur. A frozen shoulder is accompanied by inflammatory side effects and is always extremely uncomfortable.

The Most Common Causes of Shoulder Pain

The joint with the greatest amplitude of movement is the shoulder joint, this is possible because it is stabilized by tendons and muscles. As a result, the shoulder is prone to disease and wear-and-tear injuries. The result is shoulder pain, which often requires specialized treatment. But what diseases and injuries are these?

Muscle tension

Muscle tension in the neck/shoulder area often leads to painful restriction of movement of the cervical spine and shoulder joint. They occur particularly in people who have a sedentary occupation and have very little exercise in their spare time.

Joint Wear

Wear and tear on the joints, the so-called osteoarthritis of the shoulder joint, in which the cartilage layer on the joint surfaces constantly decreases, leads to shoulder pain and an increasing restriction of shoulder movement.

Impingement syndrome or bottleneck syndrome is based on an anatomical peculiarity of the bone acromion. In the case of a tilted acromion, there is little space between the acromion and the ball. The lubricant between the muscle and the rotator cuff, the bursa subacromial, is permanently irritated and can lead to chronic pain in the joint.

Joint and Tendon Injuries

If the rotator cuff, which is the muscular system that supports the shoulder joint, is torn, sudden shoulder pain occurs. If the biceps tendon tears, it is called a biceps tendon rupture, and it produces almost excruciating sharp pain.

A dislocated shoulder joint (shoulder dislocation) or a fracture of the upper arm near the shoulder area or collarbone is also associated with shoulder pain. Falls or instability of the shoulder joints is often responsible for these causes. In old age, a relatively trivial trauma is enough for a fracture of the upper arm.


If shoulder pain occurs as a result of a fall or blow, there is a possibility that the joint is bleeding. People with blood clotting disorders are particularly at risk here.


If calcium crystals adhere to the tendon insertions, this is called a calcified shoulder (calcareous tendinosis), this limits mobility and causes persistent pain.

Nerve Injuries

If the median nerve of the arm is damaged in the area of ​​the carpal tunnel, this is known as carpal tunnel syndrome. This not only causes pain in the forearm but also in the shoulder, painful shingles are also among the triggers of shoulder pain.

There are many causes of shoulder pain. To clarify and medically diagnose the correct cause of your existing shoulder pain, you should consult our orthopedic practice.

What are the typical symptoms of shoulder pain?

  • Movement restrictions

  • Limitation of daily activities

  • Instability in the shoulder joint

  • Rubbing noises in the shoulder joint.

  • Loss of arm strength

  • Sensations of cold, tingling, and numbness in the shoulder.

  • Swelling, bruising, and deformities in the shoulder area

  • Radiating pain throughout the upper arm, forearm, and in the cervical and thoracic spine region

  • Pain at night

How to Prevent Shoulder Pain?

Ergonomic workplace

If your shoulder pain is due to muscle strain from frequent desk work, you should establish an ergonomic workplace. In this way, you will avoid an uneven load on the muscles of the shoulder, neck, back, and the associated tension. Make sure the table and chair are at the correct height, the correct distance from the keyboard, and that your palm is facing the keyboard. A standing desk, whose height can be adjusted to suit your height, is also recommended.

Targeted training

Stretching exercises are recommended in combination with physiotherapy, this involves guided stretching of the neck and shoulder muscles, through small stretching and muscle release routines. Moderate shoulder pain can often be relieved with these types of practices.

For chronic shoulder pain due to osteoarthritis or calcified shoulder, those affected often get used to a relief posture, which causes the shoulder muscles to shorten over time. To counteract this, the muscles must be stretched regularly.

Relaxation techniques

Stress, tension, and everyday worries are often (partly) responsible for shoulder pain. Relaxation techniques can help relieve muscles, tendons, ligaments. Exercises such as progressive muscle relaxation, autogenic training, and yoga.

The biggest enemies of the shoulder are poor posture and lack of movement. The following measures can also provide relief in everyday life or prevent shoulder pain:

  • Regular, non-stressful movement of the shoulders, such as swimming.

  • Avoid long overhead work with heavy loads, the weight should be carried close to the body so that it can be evenly distributed on both sides

  • Take regular breaks from permanent sedentary activities, loosen your shoulders and neck with relaxation exercises, and stand up regularly throughout your day.

How is shoulder pain diagnosed?

In most cases, the diagnosis of shoulder pain is made by a medical specialist. For this purpose, the person must be examined in detail. Initially, your doctor will ask about your medical and family history. From your answers will emerge the first indications of the possible causes. During the exam, the doctor locates the exact point of pain and determines how flexible the shoulder is. He also checks the function of the muscles of the shoulder joint using special examination methods and techniques.

What therapies are available to treat shoulder pain?


For the pharmacological treatment of shoulder pain, mainly anti-inflammatory and analgesic drugs are administered, the so-called non-steroidal anti-inflammatory drugs (NSAIDs). These include, for example, diclofenac or ibuprofen. However, with higher doses or long-term use, side effects on the gastrointestinal tract are possible. To avoid side effects, sports ointments can also be used directly on the affected shoulder.

Cortisone injection for inflammatory changes in the tendons of the shoulder or bursitis is widespread. However, long-term therapy can cause side effects on soft tissues, tendons, and ligaments.

Conservative Therapy

Shoulder Restoration


The mobility of the shoulder joint and the position of the humeral head below the acromion depend on the balance of the muscles and tendons around the shoulder joint. Therefore, shoulder pain or metabolic problems in the soft tissues can be treated particularly well with physical therapy.

Physiotherapy of the shoulder joint has the following goals:

  • Relieve muscle spasms

  • Correct misalignments

  • Establish muscle balance

  • Balance the rotator cuff muscles

  • Improve metabolism to eliminate inflammation (frozen shoulder) or calcification (calcified shoulder)

  • Optimization of healing processes after shoulder injuries or tendon degeneration

Shock Wave Therapy

In shock wave therapy, precisely aligned pressure waves are intended to destroy painful deposits in the joints by being directed at the affected tissue. One of the most widespread applications of shock wave therapy in orthopedics is the treatment of calcified shoulders. Shock waves specifically contribute to the dissolution of painful calcium deposits in the supraspinatus tendon. Shock wave therapy can also help with inflammatory changes in the shoulder, such as frozen shoulder or adhesive capsulitis.

Other physical therapies

In addition to shock wave therapy, other physical therapy methods can also be used. Physical forces such as heat, cold, mechanical, or electricity act on muscles, tendons, and other tissues, thereby relieving pain.

Physical treatments include:

  • Cold therapy (cryotherapy)

  • Heat applications

  • Shock wave therapy

  • Ultrasound therapy

  • Electrotherapy

  • Massages

  • Manual therapy and chirotherapy

A visit to the doctor is always advisable if you suffer from severe and persistent pain. There are also other times when you should see a doctor right away, such as sudden severe shoulder pain, especially if the contour of the shoulder changes, and is accompanied by swelling after an accident.

Shoulder pain is treatable and even curable, for that, you need professional advice and the application of appropriate therapies, do not resign yourself to living with pain.

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